March 22, 2018 at 2:05 pm #841Archived PostsModerator
Thoughts please Female 78 years old – Severe Bouts of Sickness for 9 years
Hello, I would value your insights and clinical considerations re this 78 year old lady who has consulted with me in desperation for some help.
This lady is fit and well and generally in robust health. However, for the past 9 years she has been suffering from severe episodes of vomiting. There is no warning or build up to these episodes, but for a few minutes preceding the vomiting she will have a sense that she is going to be sick. The vomiting will last for several hours and as a result she can be incapacitated for one to two days after the episodes, which she is keen to avoid, especially in light of her age.
Currently she is experiencing approximately 1-2 episodes every 6 week. In 2014, the vomiting was also accompanied by sever diarrhoea, this worsening of symptoms lasted for 18-24 months and she is now back to severe vomiting only.
Prior to seeing me she has had, MRI and CT scans, Blood tests and investigations through a private gastroenterologist with no identified imbalances or diagnosis. The consultant prescribed an antibiotic 18 months ago aimed at possible SIBO but the client has no further information related to this treatment- this resulted in no change to her symptoms.
Two further aspects to note is that at approximately the same time as the vomiting started my client was diagnosed with an underactive thyroid, following a fall (she was asymptomatic) and now takes Thyroxine 75mg daily.
A recent GI Map via Invivo Clinical has revealed -Very high calprotectin, 336ug with reference range <50ug/g, H Pylouri High 5.0e4 reference range < 1.0e3, so my understanding is the level of concern is not high concerning this, some dysbiosis, and high levels of Endolimax nana 1.05e4 reference range < 1.00e4
I have just had a review with this client, with the GI Map result, and at the end of the consultation it also emerged that she is about to go for a root canal treatment and that this will be approximately her 12th root canal treatment.
I have asked her to obtain more information from her dentist for me- I am concerned that toxicity may be an underlying mediator of her symptoms. A food and symptoms diary has revealed no clear food associations to trigger the vomiting
I have recommended an anti-inflammatory diet, with daily bone broths, stewed apples, turmeric and ginger teas, and healthy fats I have also recommended that she chew her food well. Supplement recommendations: Allergy Research Saccharomyces Boulardii 1 TDS, Biotics Research Immuno Gg 2 TDS, and a digestive enzyme as Elastase was slightly lower than optimal for 4-6 weeks prior to review.
I would really value your thoughts and other areas to consider in regard to this case and suggestions for additional investigations, I had been considering testing for histamine intolerance and heavy metal toxicity, but would like to get a wider view on this before asking my client to spend any more of her savings, and to know if In your experience would the gut imbalances that have been identified via the GI map be mediating her symptoms of vomiting and explain the high levels of Calprotectin?
Posted By Ruth Taylor 22/3/2018
March 5, 2019 at 2:11 pm #844Christine BaileyModerator
Many thanks for your question regarding your client who has been experiencing sickness for 9 years and despite scans and tests still is not sure of the likely cause.
In view of the health history described and the onset of symptoms I would consider that the infections and imbalances identified with the stool test could be linked to her symptoms. I would suggest looking at a protocol to remove the Helicobacter as she is experiencing various symptoms that could be linked and the Endolimax nana.
It is clear that there is an issue in the gut as the calprotectin is raised so it is clear her immune system is reacting. It may be that your client will have to consider antibiotics although the triple therapy approach to eradicating H. pylori is not overly successful. So, in addition or as an alternative add in supplements that may be helpful for eradication of both. You may have to undertake this for 6 weeks for effect. In addition, dietary intervention can be helpful to help with Helicobacter.
A number of other symptoms may be associated with H. pylori infection, including:
lack of appetite, or anorexia
unexplained weight loss
Some of the drugs that are used in a triple therapy treatment include:
proton-pump inhibitors (PPI), such as lansoprazole (Prevacid), esomeprazole (Nexium), pantoprazole (Protonix), or rabeprazole (AcipHex)
metronidazole (for 7 to 14 days)
amoxicillin (for 7 to 14 days)
Avoid salt is important which can facilitate its growth. Probiotics help maintain the balance between good and bad gut bacteria. According to a 2012 study, taking probiotics before or after standard H. pylori treatment may improve eradication rates. Antibiotics kill both good and bad bacteria in your stomach. Probiotics help replenish good bacteria. They may also reduce your risk of developing yeast overgrowth. Researchers found evidence to suggest that the bacteria Lactobacillus acidophilus delivers the best results.
Yi-Qi Du et al Adjuvant probiotics improve the eradication effect of triple therapy for Helicobacter pylori infection. World J Gastroenterol. 2012 Nov 21; 18(43): 6302–6307. https://tinyurl.com/y9ycnb4r
Green tea. A 2009 study on mice showed that green tea may help kill and slow the growth of Helicobacter bacteria. The study found that consuming green tea before an infection prevents stomach inflammation. Consuming the tea during an infection reduced the severity of gastritis.
Stoicov et al , Green tea inhibits Helicobacter growth in vivo and in vitro. Int J Antimicrob Agents. 2009 May; 33(5): 473–478. https://tinyurl.com/yb5oj78d
Honey. Honey has shown antibacterial abilities against H. pylori. Additional research supports this conclusion. No research to date has shown that honey can eradicate the bacteria on its own. Researchers suggest that using honey with standard treatments may shorten treatment time. Raw honey and Manuka honey may have the most antibacterial effects.
Ayala et al Exploring alternative treatments for Helicobacter pylori infection. World J Gastroenterol. Feb 14, 2014; 20(6): 1450-1469 https://tinyurl.com/ybabezrs
I have also found Matula tea which can be purchase online can be helpful for clients.
Olive oil may also treat H. pylori bacteria. A 2007 study showed that olive oil has strong antibacterial abilities against eight H. pylori strains. Three of those strains are antibiotic-resistant. Olive oil also remains stable in gastric acid.
Romero et al. In Vitro Activity of Olive Oil Polyphenols against Helicobacter pylori J. Agric. Food Chem., 2007, 55 (3), pp 680–686 https://tinyurl.com/yag82sxn
Licorice root is a common natural remedy for stomach ulcers. It may also fight H. pylori. According to a 2009 study, licorice root doesn’t directly kill the bacteria, though it can help prevent it from sticking to cell walls. Obviously do not use solid licorice extract if there is concern with blood pressure.
Whittischer et al. Aqueous extracts and polysaccharides from Liquorice roots (Glycyrrhiza glabra L.) inhibit adhesion of Helicobacter pylori to human gastric mucosa. Journal of Ethnopharmacology Volume 125, Issue 2, 7 September 2009, Pages 218-223 https://tinyurl.com/y8tyw5qz
A compound in broccoli sprouts called sulphoraphane may be effective against H. pylori. Research on mice and humans suggests that it reduces gastric inflammation. It also may lower bacteria colonization and its effects. A study on people with both type 2 diabetes and H. pylori showed that broccoli sprout powder fights the bacteria. It also improved cardiovascular risk factors.
Mirmiran et al. A comparative study of broccoli sprouts powder and standard triple therapy on cardiovascular risk factors following H.pylori eradication: a randomized clinical trial in patients with type 2 diabetes Diabetes Metab Disord. 2014; 13: 64.
Consider as well trigger foods; for some people fatty foods and spicy foods can increase the feelings of nausea. I would also check her thyroid medication is appropriate and that the balance of FT4 and FT3 is optimal – not too high or low as this could also trigger symptoms. If you suspect fatty foods are a problem then gallbladder support can be helpful for nausea. Once you have eradicated the pathogens you will need to replenish gut flora and lower inflammation and heal the gut which may all help reduce symptoms.
In the meantime she may find soothing foods – cooked, soups, slow cooked dishes helpful and of course ginger, turmeric and ginger tea. Consider as well if she has trouble balancing her blood sugar – try and encourage her to snack regularly if blood sugar dips significantly. I would also consider at this stage avoiding gluten which can be aggravating to the gut.
The following supplements are suggested for you to consider in light of your relevant expertise and intimate understanding of the needs of your client or patient. It is not intended for them all to be taken, but rather just those that you select. They may be used in isolation or as part of a multi supplement strategy, but at all times the consideration of their use should be tied into the specific needs of the individual you are responsible for.
Please consider these suggestions in light of the other clinical information pertaining to this individual. If you have any more information about the specific problems this individual is experiencing, further refinement of these suggestions may be considered. I hope this information is helpful, and if you have any further questions or information specific to the problems this individual is experiencing, please do provide feedback.
Vs Helicobacter pylori
Mastica (ARG) – take 2 three times daily – http://tinyurl.com/hnzk9vy
Lactobacillus plantarum, rhamnosus, salivarius (ARG) – take 1-2 caps twice times daily https://tinyurl.com/z9g65f2
Lactobacillus Culturelle GG (ARG) – take 1 twice daily – https://tinyurl.com/hz9q3yh
Licorice Solid Extract (ARG) – take 1tsp twice daily – not suitable if blood pressure issues
Sano Gastril (ARG) – suck 1-2 when feeling sick – https://tinyurl.com/h3mttmd
ADP Oregano (BRC) – take 3-4 with each meal – https://tinyurl.com/hdjg9c5
Vitamin D3 Complete (ARG) – take 1 daily based on vitamin D testing and levels – https://tinyurl.com/jqx3ttt
For digestive support and gallbladder support
Beta-TCP (BRC) – take 1-2 with each meal – https://tinyurl.com/hskrbum
Full Spectrum Digest (ARG) – take 1-2 with each meal
I hope this helps with your client
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